Breast Reconstructive Surgery

Among women’s oncological diseases, breast cancer is the most common disease affecting women worldwide. According to global statistics, it is diagnosed in 16% of cancer cases in patients of all age groups, which is 1.25 million cases per a year. This is why the best efforts of global medical practice are aimed at the development of new methods and approaches both for the diagnostics and treatment of breast cancer, and for the subsequent breast reconstruction.

Thanks to the advanced achievements of Finnish health professionals in the sphere of early diagnostics, and also the advances in conservative and surgical treatment approaches, patient recovery takes place in more than 70% of oncological disease cases.

Maximum attention is paid to rehabilitation after performing treatment and reconstructive surgery, with the aim of providing the same quality of life for patients as before the disease.

Breast-conserving surgeries, during which only the part of the breast with the tumour and the surrounding tissues are extracted, are currently considered to be the most advanced course of curative treatment of breast oncology. This method allows preserving the organ and conducting radial and cytostatic treatment. Following effective treatment it also allows a return to rehabilitation measures for breast reconstruction.

These may include:

fitting of prosthesis,

lipofilling – correction using fat self-tissue of the patient,

other methods, which the physician can recommend based on the specific circumstances and health status of the individual patient.

Methods of later breast reconstruction after mastectomy

It is now possible to reconstruct a breast even after its complete extraction (mastectomy). As a rule, reconstruction surgery is performed in the period 1-3 years after the mastectomy. By using a patient’s own tissues it is possible to reconstruct a breast that is practically identical to the natural breast.

Based on each individual case, the oncoplastic surgeon chooses the most effective method, using TRAM and DIEP-flap or LD-reconstruction.

TRAM-method is a transplantation of skin and fat abdomen tissues with the muscle of the anterior abdominal wall (having blood vessels) for complete reconstruction of breast shape. The improved variant of this method is DIEP-operation — transplantation of skin alone with subcutaneous fat layer without injuring the abdominal muscles, which makes sense in the reconstruction of a larger breast.

LD-reconstruction method is used for the reconstruction of small breasts of very slim patients lacking excess fat and skin on their abdomen. For this reason, the flap of skin, fatty tissue and necessary muscle piece for the formation of a new breast are transplanted from the back. This leaves only a negligible surgical scar on the back. And for symmetry, maintenance surgeries can be performed on both sides of the back.

World-class expertise breast reconstruction expertise

Doctor Helena Puonti has performed over 300 complex microsurgeries for breast reconstruction using the method of free tissue transplantation from the anterior abdominal wall.

She has also pioneereed several technologies for tissue transplantation. For example, simultaneously taking the advantage of the TRAM and DIEP-methods, she forms a flap from the anterior abdominal wall in a special way so that the integrity of the muscular layer is not damaged, and the graft has a sufficient blood supply network. As a result, the possibility for postoperative hernia development is completely eliminated, and faster engraftment of implants takes place.

More than 90% of all reconstructive operations performed at Clinic Helena are carried out using the patient self-tissue transplantation method, which is rare for plastic surgery clinics in Finland.

Since 2001 Doctor Helena Puonti has also been developing a unique microneurovascular technology which restores sensitivity as the reconstructed breast recovers. She has shown that it is possible to recover natural sensitivity in the breast skin when even just one nerve of skin-muscular tissue from the abdominal cavity anterior wall is sewed to the sensitive nerve fibre of the breast.

This innovative technology is the basis for a soon-to-be-published thesis. Many patients come to Clinic Helena clinic not for only breast shape, but also to recover breast sensitivity.

Thanks to advances in oncology, breast cancer can now be successfully treated with many different methods. Oncoplastic surgeons can also reconstruct a breast that is natural and symmetrical in shape and size, providing patients with the same quality of life as before before the detection of the disease.